韦格纳肉芽肿病合并静脉血栓临床分析  

Clinical analysis of venous thromboembolism with Wegener＇s granulomatosis

作　　者：张立民[1] 吴庆军[1] 张国华[1] 曾小峰[1] 

机构地区：[1]中国医学科学院北京协和医院风湿免疫科,100032

出　　处：《中华风湿病学杂志》2010年第2期107-109,共3页Chinese Journal of Rheumatology

基　　金：“十一·五”国家科技支撑计划（2008BA159B02）

摘　　要：目的分析总结韦格纳肉芽肿病（WG）合并静脉血栓（VTE）的发病率、与疾病活动度的关系及其临床特点，寻找发生VTE的危险因素。方法回顾性分析2000年2月至2008年4月我院WG住院患者临床资料。结果总计71例WG患者中合并VTE7例（10％），2例肺栓塞（PE），5例深静脉血栓（DVT），全部发生在疾病活动期。临床表现各异。合并VTE组与未合并VTE组比较，男性（P=0．012）、尿蛋白定量（24h）≥3．0g（P=0．001）及肌酐增高（P=0．004）2组问差异有统计学意义，外伤、肿瘤、药物等常见的危险因素2组之间差异兀统计学意义。结论WG患者VTE发病率增高，尤其在WG活动期。男性、尿蛋白定量（24h）≥3．0g及肌酐增高为危险因素，对存在危险因素的WG患者应警惕VTE的可能。Objective To determine the prevalence of VTE in wegener＇s granulomatosis （WG） and its relation with disease activity as well as the risk factors. Methods Patients diagnosed with WG between 2000 and 2008 were included. Retrospective, systematic analysis and comparison were made between the characteristics of patients in the venous thromboembolism （VTE） group and non-VTE group. Results Seventy-one patients with WG were included. Seven VTEs （2 pulmonary emboli, 5 deep venous thromboses） occurred in association with WG, all occurred during active phase of the disease. The prevalence of VTE was 9.8%. According to univariate analysis, male sex, nephritic range proteinuria （24 h） ≥3.0 g and elevated serum creatinine were significantly associated with VTE. There were no significant differences in classic risk factors between patients with and without WG-associated VTE. Conclusion Patients with WG have an increased risk of developing VTEs, especially when WG is active. Male sex,nephritic range proteinuria （24 h） ≥3.0 g and elevated serum creatinine are risk factors. Clinicians taking care of patients with WG should be highly aware of the risks for VTE and maintain a low threshold for evaluating patients for possible deep venous thrombosis or pulmonary embolism.

关 键 词：韦格纳肉芽肿病 静脉血栓形成 危险因素 

分 类 号：R593.9[医药卫生—内科学] R543.6[医药卫生—临床医学]